In 2012, Ghana became one of the first sub-Saharan African nations to
receive GAVI support for the introduction a newly developed pneumococcal
conjugate vaccine, PCV13. While the introduction has been touted as a success,
there has been little formal evaluation of the vaccine: its cost-effectiveness in the
Ghanaian context and the success of implementation to date. This thesis attempts
to evaluate the appropriateness of the vaccine as a tool to combat childhood
pneumonia in Ghana. The primary mode of analysis is a cost-effectiveness
analysis of the vaccine for Ghana. However, the thesis also evaluates the
sustainability and effectiveness of this intervention and concludes with a brief
qualitative comparison with other nations.
Based on the results of this cost-effectiveness analysis, PCV13 is a highly
cost-effective intervention for Ghana, with an incremental cost-effectiveness ratio
of $313.34 per DALY averted. Vaccination would be expected to avert 1,324
deaths and 63,939 cases of pneumonia among the 2007 birth cohort during the
first five years of life. These findings are robust to changes in key parameters.
Furthermore, the initial implementation appears to have been successful as
measured by high coverage, although public health impact has not been observed
to date. However, the long-term success of this immunization program hinges
upon Ghana's ability to procure funds to finance the program as it graduates from
GAVI pricing and to ensure access for all eligible children. Other countries
considering introduction of a pneumococcal conjugate vaccine should consider
cost-effectiveness, affordability, the strength of their existing EPI program, and
the broader political and social context to determine whether the vaccine is an
appropriate public health intervention.